Investigation Diabetic Amputations in Walsall: A Pilot Study
PHE ePoster Library. Myers P. Sep 12, 2017; 186613; 164
Paulette Myers
Paulette Myers
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Abstract Diabetes is an increasing health threat, with over three million people living with the condition in England. Diabetic foot ulcers can lead to lower extremity amputation, which can range in severity from the removal of one single toe to the amputation of a lower limb. There has been a notable increase in Diabetic amputations for Walsall registered patients since 2013, with numbers almost doubling between 2014 and 2015. This work provides a summary of an audit of process of care for 58 Walsall registered diabetic patients leading up to amputation. A total of 60 diabetic amputations were performed during 2015-16 of differing severity.Routes and times to amputation from first consultation were examined with respect to predictors, amputation severity and process risk scores. It was observed that undiagnosed Type 2 diabetics frequently required immediate amputation, mortality rates were also higher for this group. Known diabetics, particularly Type 1, showed a longer route to amputation demonstrating effective management including foot care. This pilot study has allowed Public Health Walsall provide recommendations for diabetes care and to facilitate systems to identify high risk patients by applying process and outcomes scoring. Additionally, a template for referrals to the diabetic podiatry clinic post amputation was produced to give consistency in the information collected. Going forward this will improve understanding of the routes to amputation and what preventative measures could be added to give a reduction.
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